TY - JOUR
T1 - Nonsteroidal anti-inflammatory drug use is associated with cancer risk reduction in chronic dialysis patients
AU - Ou, Shuo Ming
AU - Chen, Yung Tai
AU - Chao, Pei Wen
AU - Lee, Yi Jung
AU - Liu, Chia Jen
AU - Yeh, Chiu Mei
AU - Chen, Tzeng Ji
AU - Chen, Tzen Wen
AU - Yang, Wu Chang
AU - Li, Szu Yuan
N1 - Funding Information:
This study was based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, and managed by the National Health Research Institutes. The conclusions presented in this study are those of the authors and do not necessarily reflect the views of the Bureau of National Health Insurance, the Department of Health, or the National Health Research Institute. This research was funded by a Taipei Veterans General Hospital research grant (no. V100B-030).
PY - 2013/7
Y1 - 2013/7
N2 - Previous studies have shown that nonsteroidal anti-inflammatory drug (NSAID) use might be associated with a lower risk of developing cancer in the general population. Patients on dialysis have increased risk for cancer, but there are no studies to determine the relationship between NSAID use and cancer risk in these patients. To identify any association between NSAID use and cancer risk in patients with end-stage renal disease on dialysis, we used Taiwan's National Health Insurance database to conduct a nationwide population-based, propensity score-matched cohort study. All cancers between groups were compared by Cox proportional hazards models. Compared to nonuse of NSAIDs, the use of non-COX-2-selective inhibitors (hazard ratio 0.81, 95% confidence interval 0.67-0.97) or COX-2-selective inhibitors (0.78, 0.62-0.98) was associated with a lower risk of developing cancer. NSAID use reduced the risk of respiratory (0.39, 0.19-0.79), breast (0.41, 0.19-0.89), kidney (0.58, 0.38-0.88), digestive tract (0.64, 0.49-0.85), and bladder cancers (0.73, 0.55-0.96). NSAID use, however, significantly increased risk for upper gastrointestinal bleeding (odds ratio, 1.15, 1.07-1.23) but not adverse cardiac or cerebrovascular events. Thus, NSAID use was associated with a lower risk of developing cancer in chronic dialysis patients; however, they should still be used with caution due to the side effects of gastrointestinal bleeding.
AB - Previous studies have shown that nonsteroidal anti-inflammatory drug (NSAID) use might be associated with a lower risk of developing cancer in the general population. Patients on dialysis have increased risk for cancer, but there are no studies to determine the relationship between NSAID use and cancer risk in these patients. To identify any association between NSAID use and cancer risk in patients with end-stage renal disease on dialysis, we used Taiwan's National Health Insurance database to conduct a nationwide population-based, propensity score-matched cohort study. All cancers between groups were compared by Cox proportional hazards models. Compared to nonuse of NSAIDs, the use of non-COX-2-selective inhibitors (hazard ratio 0.81, 95% confidence interval 0.67-0.97) or COX-2-selective inhibitors (0.78, 0.62-0.98) was associated with a lower risk of developing cancer. NSAID use reduced the risk of respiratory (0.39, 0.19-0.79), breast (0.41, 0.19-0.89), kidney (0.58, 0.38-0.88), digestive tract (0.64, 0.49-0.85), and bladder cancers (0.73, 0.55-0.96). NSAID use, however, significantly increased risk for upper gastrointestinal bleeding (odds ratio, 1.15, 1.07-1.23) but not adverse cardiac or cerebrovascular events. Thus, NSAID use was associated with a lower risk of developing cancer in chronic dialysis patients; however, they should still be used with caution due to the side effects of gastrointestinal bleeding.
UR - http://www.scopus.com/inward/record.url?scp=84879688027&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879688027&partnerID=8YFLogxK
U2 - 10.1038/ki.2013.79
DO - 10.1038/ki.2013.79
M3 - Article
C2 - 23486520
AN - SCOPUS:84879688027
SN - 0085-2538
VL - 84
SP - 198
EP - 205
JO - Kidney International
JF - Kidney International
IS - 1
ER -
